KENNETH LASSITER (NPI# 1770180903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770180903 |
| Entity Type | Individual |
| Full Name | KENNETH LASSITER |
| Credential | MS, ATC, LAT |
| Practice Address |
1200 Murchison Rd Fayetteville NC 28301-4252 |
| Mailing Address |
6528 Tampico Ct Fayetteville NC 28303-2334 |
| Practice Telephone | 3369530668 |
| Mailing Telephone | 3369530668 |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
20000190028 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
1200 MURCHISON RD |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28301-4252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396899100 | Jeffrey E Cassisi | Psychologist | 1200 Murchison Rd, Dept of Psychology, Fayetteville State University, Fayetteville, NC 28301-4252 | 2007-01-22 |
| 1548883325 | Gloria Shadell Wells | Counselor | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2020-05-27 |
| 1528547718 | Fayetteville State University | Pharmacy | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2018-08-09 |
| 1063990281 | Fayetteville State University | Clinic/Center | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2018-07-31 |
| 1609244482 | Erica Campbell | Counselor | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2015-09-10 |
| 1861755258 | Carlitta Michelle Moore | Specialist/Technologist | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2012-06-20 |
| 1093947228 | Marjorie Stokes | Registered Nurse | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2009-08-21 |
| 1538353404 | Indira Tyler | Registered Nurse | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2007-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726219 | Jenna Michelle Odneal | Behavior Technician | 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 | 2020-10-02 |
| 1790390094 | Jessica Shellman | Counselor | 408 Person St. Ste 103, Fayetteville, NC 28301 | 2020-09-14 |
| 1487205951 | Martha K Richardson | Technician | 720 Teachers Dr, Fayetteville, NC 28301 | 2019-09-25 |
| 1013568161 | Angela Rena Locklear | Counselor | 211 Lamon St, Fayeteville, NC 28301 | 2019-09-20 |
| 1619535747 | Teresa Wilson | Contractor | 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 | 2019-06-04 |
| 1912461815 | Catherine Stevenson Nwogalanya | Community Health Worker | 1103 Hillsboro St., Fayetteville, NC 28301 | 2019-01-24 |
| 1811443187 | Michael Carroll | Counselor | 308 Peterson Place, Fayetteville, NC 28301 | 2016-08-28 |
| 1023499886 | Latifa Fedai | Nurse Practitioner | 380 Person Street, Fayettevill, NC 28301 | 2015-06-17 |
| 1265868939 | Aci Support Specialists | Community/Behavioral Health | 1725 Venna Drive, Fayetteville, NC 28301 | 2013-09-25 |
| 1871929547 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 2820 Copenhagen Drive, Fayetteville, NC 28301 | 2013-09-25 |
| Find all providers in zip 28301 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945473 | Brooke Hollingworth | Physical Medicine & Rehabilitation | 3900 N Parkview Dr Ste 202, Fayetteville, AR 72703-6398 | 2020-09-04 |
| 1841784170 | Jordan Drew Bettleyon | Physical Medicine & Rehabilitation | 5400 Ramsey St, Fayetteville, NC 28311 | 2018-06-20 |
| 1144741976 | Provision Physical Therapy,llc | Physical Medicine & Rehabilitation | 105 Commerce Dr Ste B, Fayetteville, GA 30214-7352 | 2017-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679130744 | Mojo Sportclinic, LLC | Physical Medicine & Rehabilitation | 6859 Monument Dr, Wilmington, NC 28405-4178 | 2019-05-23 |
| 1679138176 | Jeneva Gatses | Physical Medicine & Rehabilitation | 13759 Cinnabar Pl, Huntersville, NC 28078-5342 | 2019-05-09 |
| 1285159905 | Austin John Hille | Physical Medicine & Rehabilitation | 400 Landis Ct. #203, Asheville, NC 28806 | 2017-08-03 |
| 1174052138 | Olivia Sabo | Physical Medicine & Rehabilitation | 8814 Red Rd, Rockwell, NC 28138-6500 | 2017-06-05 |
| 1588296719 | Douglas Maccallum | Physical Medicine & Rehabilitation | 2121 E Williams St Ste 108, Apex, NC 27539-7765 | 2020-02-05 |
| 1972153419 | Meredith Elise Bland | Physical Medicine & Rehabilitation | 3475 Erwin Rd, Durham, NC 27705-0005 | 2019-09-17 |
| 1275188484 | Edward Albert Marshall Jr. | Physical Medicine & Rehabilitation | 224 East Wilson Street, Wingate, NC 28174 | 2019-08-05 |
| 1881174878 | Jaela Marie Wilson | Physical Medicine & Rehabilitation | 1801 Fayetteville St, Durham, NC 27707-3129 | 2018-08-19 |
| 1154813756 | Willie Phillips II | Physical Medicine & Rehabilitation | 1900 Selwyn Ave, Charlotte, NC 28274-0001 | 2018-05-31 |
| 1437665361 | Novant Medical Group, Inc. | Physical Medicine & Rehabilitation | 8035 Providence Rd Ste 100, Charlotte, NC 28277-9716 | 2017-12-14 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.